From a View of the Hospital as a System to a View of the Suffering Patient

Purpose: Hospitals aspire to provide patient-centered care but are far from achieving it. This qualitative mixed methods study explored the capacity of hospital directors to shift from a hospital systemic-view to a suffering patient-view applying the Salutogenic theory.Methods: Following IRB, we conducted in-depth narrative interviews with six directors of the six Israeli academic tertiary public hospitals, focusing on their managerial role. In a second meeting we conducted vignette interviews in which we presented each director with a narrative of a suffering young patient who died at 33 due to medical misconduct, allowing self-introspection. Provisional coding was performed for data analysis to identify categories and themes by the three dimensions of the sense-of-coherence, an anchor of Salutogenics: comprehensibility, manageability, and meaningfulness.Results: While at the system level, directors reported high comprehensibility and manageability in coping with complexity, at the patient level, when confronted with the vignette, directors acknowledged their poor comprehensibility of patients' needs and patient's experience during hospitalizations. They acknowledged their poor capacity to provide patient-centered care. Meaningfulness in the narrative interview focused on the system while meaningfulness in the vignette interview focused on providing patient care.Conclusions: The evident gaps between the system level and the patient level create lack of coherence, hindering the ability to cope with complexity, and are barriers to providing patient-centered care. To improve the delivery of patient-centered care, we suggest ways to consolidate the views, enabling the shift from a systemic-view to a patient-view.

Adult learning facilitators' professional identity: An exploratory review based on a selection of empirical studies

This paper is an exploratory review of selected literature that focused on adult learning facilitators' professional identity. We employed the snow-ball technique for selection and followed the review protocol by Beijaard, Meijer, and Verloop (2004) to explore empirical studies that discussed how professional identity is defined, what constructs encompass professional identity, which methodologies are relevant when studying professional identity and what are adult learning facilitators' common characteristics as professionals. Our review shows that the studies included have a common understanding of professional identity: it is conceived of as a dynamic construct which encompasses job motivation and future vision as well. Narrative interview with biographical perspectives was used as the main research method in all the reviewed studies. This exploratory review offers a set of perspectives which could be considered as entry points into an in-depth (empirical) study of adult learning facilitators' identity formation in various regional and national contexts.

Men’s Experiences in Feminized Occupations on the Example of Selected Professions

The issues raised in this article concern the functioning of men in feminized professions. The aim of the study was to gather experiences of men working in jobs dominated by women. The research included twenty men and was conducted between February and April 2020 in Poland, using a narrative interview. Research problems were focused on men’s attitudes toward their jobs, the assessment of career advancement opportunities, advantages and disadvantages resulting from working in a feminine environment, relations with colleagues and employers, and reactions of their environment. The interviews revealed a relatively positive image of men’s experiences relating to working with women. The respondents did not notice any specific difficulties in their professions caused by gender stereotypes. They expressed a view that working among women was like any other job. Few difficulties mentioned by the respondents were related mostly to the issue of assistance in activities requiring strength or technical knowledge rather than competences related to a specific profession. Moreover, the interviewees treated their professions as an opportunity for self-development and for gaining experience that they would not have been able to gain in a typically male environment.

The Application of Problem-Centered Interview as a Method of Pedagogical Research

The purpose of the article is to present the qualitative research method known as Problem-Centered Interview and its potential application in pedagogical research. The author demonstrates the main assumptions and stages of the method, simultaneously analyzing the possible benefits and limitations of its use. The originality of the method is confronted with other types of interviews, i.e.: active, in-depth and classical narrative interview. The application of unique qualities of the method,such as: administering three types of reasoning (deductive, inductive and abductive), addressing the prior knowledge bias of the researcher and taking into account afalsification in the validation process, all of which increase the credibility of research conclusions. The Problem-Centered Interview which is placed between the objectivist Grounded Theory and constructionism is able to provide a new insight into education and upbringing. The application of the method makes it possible for the research itself to become an educational situation.

Critical Events as Factors Shaping Life Experiences

The article presents the life story of an elderly woman, the sense of the quality of her life, the critical events that shaped her life, and the lessons learned from her experiences. The study adopted a biographical paradigm, which explains the importance of individual biographies in the education process and indicates the need to study the history of life as a source of knowledge about man and his learning. The main aim of the undertaken research was to recognise the meanings that the respondent gives to critical events in shaping the quality of her life. The biographical method was used, and, within it, an autobiographical narrative interview. The most significant events assessed as positive were the births of her children. The negative events were in particular: the deaths of close ones, a failed marriage and an accident. In coping with suffering, the woman was helped by: help from others, faith, strength, optimism, activity, activities for the benefit of others, and her value system. Lessons emerged from the subject’s history, helpful in her life, which can also inspire others. The narrator tried to live in harmony with her conscience and the accepted principles, which gave her satisfaction. Biographical research has an educational function. Life stories can teach what is important in life, what is worth living for, and they can lead to reflections.

From the Correspondence of Musicologist Ona Narbutienė: Letters from Composer Jeronimas Kačinskas

This paper deals with studies into the personal archive of the musicologist Ona Narbutienė (1930–2007), including a number of previously unpublished documents. Narbutienė’s musicological heritage, which has been little investigated so far, consists of books, articles, lectures, radio and TV shows, musical evenings, texts for record sleeves and CD inlays as well as the conceptual framework, the programme, and texts for the International Thomas Mann Festival in Nida. Within the context of this heritage, her lessons and lectures stand out for their special role in shaping the views, attitudes, and professional choices of the musicologists of the younger generation. The evidence of all these activities can be found in Narbutienė’s private archive compiled over many years and thus displaying the content of great historical and musicological value. The paper examines Narbutienė’s musicological interests as revealed in her personal correspondence and their relationship to certain professional imperatives. Narrative, interview, historical-analytical, and empirical research methods were employed in this study.

“I’m Getting Older Too”: Challenges and Benefits Experienced by Very Old Parents and Their Children

Very old parents and their “old” children are a growing group in industrialized countries worldwide. Since most very old persons have outlived spouses and friends, their children, many of whom have reached old age themselves, are likely to become their primary social contact and to shoulder the care provision role. However, virtually nothing is known about the nature and implications of this relationship constellation. To fill this gap, the present study explored the challenges and rewards of the very old parent-child relationship. In-depth interviews were conducted with 114 parent-child dyads (parent age ≥ 90; child age ≥ 65). Narrative interview data on challenges and rewards were audiotaped, transcribed, and then systematically reviewed and coded, identifying recurrent themes and defining categories that reflected these themes. While both challenges and rewards were present, more rewards than challenges were reported overall. However, comparing parent and child perspectives revealed that the balance of challenges and rewards was less favorable for children. Narrative data further showed that the sense of burdening their children heavily weighed on at least a fourth of parents, reflecting this as a serious concern not only for children but also for parents. Challenges reported by children were often characterized by references to children’s own advanced age and health problems, and the prolonged caregiving involvement due to their parents’ longevity. Healthcare professionals, policy makers, and families should be made aware of this increasingly common phenomenon, and specific services and policies will be needed to adequately support very old adults and their families.

Patient perspectives from the multi-disciplinary chronic pain clinic: a qualitative study

Aim: The chronic pain clinic (CPC) is a multi-disciplinary program that incorporates pharmacological and non-pharmacological methods, including First Nations healing strategies, to manage pain, improve functioning and reduce opioid misuse among patients with chronic pain in Regina, Canada. Materials & methods: The care experiences of ten current clients were explored using a narrative interview approach. Results: The CPC provides high-quality and safe care for effective chronic pain management. Clients noted pain reduction and improvements in sleep, mobility, functionality, and mood. First Nation clients emphasized the importance of traditional healing strategies. Conclusion: This unique comprehensive multi-modal approach which incorporates First Nations healing strategies is effective in supporting the unique needs of local clients.